Abstract: Objective The aim of this study was to summarize clinical feature of gastrointestinal perforation (GIP) in patients with hepatocellular carcinoma (hcc). Methods 15 patients with GIP and underlying HCC were encountered in our hospital between January 2017 and July 2024, and all patients were carefully dealt with conventionally or surgically. Results Of the 15 patients with GIP and HCC, 11 were male and 4 female, with average age of (9.4±9.8) year old; 12 patients were infected with hepatitis B virus, 1 had alcoholic liver disease and 2 were cryptogenic; all the 15 patients had abdominal pain with a median duration of 2 d(1 hour,10 d); blood WBC count was (8.3±4.9×10⁹/L) with neutrophil percentage of(82.5±9.8%), serum albumin level was (29.3±5.6 g/L), and prothrombin time activity was (59.5±10.3%); the perforated sites in stomach, duodenum, jejunum, ileum and colon were 6 cases (40.0%), 2 cases (13.3%), 1 case (6.7%), 2 cases (13.3%) and 4 cases (26.7%), respectively; three patients died after supporting treatment, with an average survival of 15 days, the remaining 12 patients underwent surgical repairment, with 3 died and 9 survived; of the 9 survivals, 2 underwent liver transplantation, 4 underwent hepatic artery embolization and/or targeted and/or immune therapy, 2 underwent internal supporting treatment and 1 had regular monitoring, the outcomes were 7 died and 2 survived, with mean survival time of (22.2±19.3) months. Conclusion The patients with HCC have the risk of GIP during invasive and systemic treatment, and an appropriate surgical repairment should be done in time once it occur.

Key words: Hepatocellular carcinoma, Gastrointestinal perforation, Clinical feature, Treatment